Individual provider Active NPI

Trevor Johnson, PT

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1699093963
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1952 E 7000 S
Salt Lake City, UT 84121-6877
Phone
(801) 495-5307
Fax
(801) 495-5303
NPI assigned
May 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1952 E 7000 S
Salt Lake City, UT 84121-6877

Mailing address

PO Box 711185
Salt Lake City, UT 84171-1185
Phone (801) 942-3311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250827005049 UT Practitioner - Physical Therapist in Private Practice 7517468986 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Land Rehabilitation LLCGroup PAC ID 9234048745, 207 clinicians

Practice addresses (Care Compare)

272 E Ctr St
Suite 103
Ivins, UT 84738-6743
Phone (435) 674-2115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Land Rehabilitation LLC Physical Therapist CurrentSince Aug 1, 2025 Accepting new patients

Locations

272 E Center St
Ste 103
Ivins, UT 84738
Phone (435) 674-2115

1952 E Fort Union Blvd
Salt Lake City, UT 84121
Phone (801) 495-5227

4179 S Riverboat Rd
Ste 110
Taylorsville, UT 84123
Phone (801) 337-4475

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273622400000",
    "number": "1699093963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711185",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841711185",
            "telephone_number": "801-942-3311",
            "fax_number": "801-495-5303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1952 E 7000 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216877",
            "telephone_number": "801-495-5307",
            "fax_number": "801-495-5303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TREVOR",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2010-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.